Provider Demographics
NPI:1508645177
Name:ROBINSON, RANDY II
Entity Type:Individual
Prefix:
First Name:RANDY
Middle Name:
Last Name:ROBINSON
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 ELMWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-8540
Mailing Address - Country:US
Mailing Address - Phone:317-397-7520
Mailing Address - Fax:
Practice Address - Street 1:707 ELMWOOD CIR
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-8540
Practice Address - Country:US
Practice Address - Phone:317-397-7520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst